上食管异位胃黏膜19例内镜分析

目的:探讨上食管异位胃黏膜的内镜、病理、临床特征,以及与Barrett食管的鉴别,以提高对该病的认识。方法:通过对临床资料进行回顾性分析,在胃镜检查过程中,退镜至食管入口上食管括约肌处时,进行仔细观察,以了解上食管异位胃黏膜的发生情况,从异常食管黏膜取活检。结果:6011例胃镜检查患者中发现19例上食管异位胃黏膜,发生率0.32%,平均年龄47.5岁,病灶大小约0.5～2.0cm,其中单病灶12例,2个病灶5例,3个病灶2例;部分患者无任何症状,部分患者可出现一些食管症状或食管外症状。结论:由于上食管异位胃黏膜发病率低,加之位置特殊,在胃镜检查中很容易被内镜医师漏诊,确诊依赖于胃镜活检及病理。

Objective ：To investigate the endo- scopic ,pathological and clinical characteris- tics of heterotopic gastric mucosa in the up- per esophagus（HGMUE） ,and compare with Barrett,s esophagus. In order to increasing recognize of HGMUE. Methods： A prospec- tive study was made among a total of 6011 consecutive patients undergoing gastroscopy examined. Special care was taken in the up- per esophageal sphincter area to make sure whether the area was HGMUE during with- drawal of the endoscope. Biopsy specimens from aberrant mucosa were obtained. Re- sults：HGMUE was found in 19 patients of 6011 ,with a prevalence of 0.32% ,With an average age of 47.5. Patch size ranged be- tween 0.5 and 2.0cm, appeared as a single patch in 12 patients, as twin patches in 5 patients, and as three patch in 2 patients. Some patients with extra gastrointestinal symptoms, some of them are asymptions, oth- ers are accompanied with esophagus sympot-ions. Conclusions： HGMUE has low inci- dence, associate with special location in the esophagus, which has been overlooked by endoscopists. Diagnosis depend on biopsy and pathology.